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America’s older population, which includes people who are age 65 or older, grew to 34.5 million in 1999. The number of older Americans is growing rapidly and has increased 10-fold since 1900. In 10 years, the “baby boom” generation will begin to turn 65, and by 2030, one-fifth of the American population will be 65 or older. The size of the older population is projected to double over the next 30 years, growing to 70 million by 2030. The population age 85 and older is currently the fastest growing segment of the older population. Projections by the U.S. Census Bureau suggest that the population age 85 and older could grow from about 4 million in 2000 to 19 million by 2050. Where Do the Elderly Live? In 1999, about half of persons 65 or older lived in nine states: California (3.6 million), Florida (2.7 million), New York (2.4 million), Texas (2.0 million), and Pennsylvania (1.9 million); Ohio, Illinois, Michigan, and New Jersey each had well over 1 million. The 65 or older population was slightly less likely to live in metropolitan areas in 1999 than younger persons. About 50 percent of older persons lived in the suburbs, 27 percent live in central cities, and 23 percent lived in nonmetropolitan areas. Living arrangements of America’s older adults are closely linked to income, health status, and the availability of caregivers. Older persons who live alone are more likely to be in poverty and experience health problems, compared with older persons who live with a spouse or a relative. In 1997, 1.6 million elderly lived in nursing homes, less than 5 percent of the elderly. The percentage of the population who live in nursing homes also increased dramatically with age, ranging from 1 percent for persons 65-74 years, to 5 percent for persons 75-84, to 19 percent for persons 85+. About 558,400 older adults live in assisted-living facilities. The use of assisted-living facilities, board and care homes, continuing-care retirement communities, and other types of facilities in addition to long-term care in a nursing home has grown over the last 15 years. Current surveys rarely distinguish between these different types of institutional settings and the characteristics of older persons within these settings, but the fact that they are increasing in numbers does indicate the growing need for health care services for frail elderly citizens.